Severity Adjustors
ICD-10 Diagnosis:
Z96.641 Presence of right artificial hip joint
Z95.1 CABG
Z89.611: Acquired absence of right leg above knee
What are allowable Z codes
FFSU
What is First Floor Set up
Accepted Abbreviations for Clinicians
"Patient continues to appear to meet CMS Chapter 8 guidelines based on their need for daily skilled therapy and/or nursing services that can only be provided in a SNF."
What is template for clinical impression of interim review.
Date clinicals are due for review
What is NDR (Next Review Date)
Admission/Interim/NOMNC review: 'Generate Outcome Report'
What is Admission review
FCI- Primary dx: MI
PLOF: amb without AD in the home and occasionally uses SPC in the community, Independent with ADL/IADLs.
PMH: HTN, MVA 10 years ago with femur fracture.
What is FCI 3
medical diagnosis for which the patient was admitted, reason the patient is receiving post-acute rehabilitation, OR acute medical condition causing the current impairment, that is/will drive the need for post-acute care
What is Primary Diagnosis
Document: You completed a review and sent nH Predict outcome by email but have not yet had a discussion about it
What is engagement tab- document yes shared nH Predict
Templated used for: "For Auth 1234567, the information within the Clinical Note was changed/corrected to reflect the actual clinical documentation received from the provider to support the request."
What is Editing Clinical Documentation Work Instruction
Case Manager informed you member admitted to the SNF facility
What is Confirm Member Admission
Medical Adjustor: Any non-stageable wounds, per CMS/MDS guidelines
What is Pressure Wound IV
Effective tool for keeping yourself organized, a place where you can gather notes, memo’s, drawings and snippets.
What is OneNote
Document: Not skilled at SNF level but it is important to document that it exists (ie BMI 40 or greater, chronic Foley Cath, unskilled chronic wounds, etc).
What is Current Problem or PMH
Go to guide for completing Clinical Notes
What is Clinical Notes Overview
Last step in review to save Clinical Notes
What is Export
Patient has documented two stage II pressure wounds & one stage III pressure wound
What is Pressure Wound III
FCI- Primary Dx: New Dx Parkinson's
PLOF: CGA with RW 75'
Comorbidities: Diabetes w/moderate to severe (decreased LE sensation) LE ulcers, visual impairments (diabetic retinopathy)
What is 4
Usually Skilled/Probably Skilled/Unlikely Skilled:
Foley Catheter
Wound Stage 1&2
General Daily Observation
What is Unlikely Skilled
Outbound Call to Member- need to confirm Name, DOB, Address
What is HIPAA grid
Comorbidities
Surgical Procedure
Isolation
CLOF-Oral Hygiene, Cognitive function
Dietary requirements
Nursing CMG
What is PDPM
FCI -Primary dx: AKI
PLOF: ambulates up to 30 ft with a RW, uses a power wheelchair for longer distances. MOD I with ADLs.
PMH: COPD on 2L O2 continuous, CAD, morbid obesity, CHF.
What is FCI 4
Clinicals received via
What is Access (portal)
What is Fax
d/t
w/
t/f
What is do not use list - Accepted Abbreviations for Clinicians
Resource for speak to aligning realistic discharge expectations
What is Applying the SNF Predict Outcome report
Alert: Update received @ 11:21
What is Clinical Updates received, review pending to be completed.